Total Protein and Albumin to Globulin Ratio Test (A/G Ratio)-Why am I having this test?

The total protein and albumin to globulin ratio test can be ordered as part of a routine physical exam or if you have symptoms such as:

• Swelling of your ankles (edema).
• Swelling of your abdomen (ascites).
• Shortness of breath due to fluid collection in your lungs (pulmonary edema).

You may also have this test if your health care provider thinks you may have:

• Liver disease.
• Kidney disease.
• Poor nutrition.
• An inability to get proteins from your diet (malabsorption).
• A condition that is causing fluid to pool in your body tissues (edema).

What is being tested?

This test measures the level of proteins in your blood. Your blood contains two types of proteins:

• Albumin. This protein carries many other important molecules in your blood. Albumin also helps keep your body fluids in balance and prevents them from leaking out of blood vessels into tissue cells.
• Globulin. This protein makes up important substances like enzymes, antibodies, and hormones. This type of protein is an important part of your immune system.

Together, the combination of albumin and globulin in your blood equals the total protein.

Some labs report the results of this test as a comparison between your level of albumin to your level of globulin (A/G ratio).

What kind of sample is taken?

A blood sample is required for this test. It is usually collected by inserting a needle into a blood vessel.

How do I prepare for this test?

Let your health care provider know about all medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines. Some medicines, including estrogen and birth control pills, can affect your protein levels.

How are the results reported?

Your test results will be reported as values. Your health care provider will compare your results to normal ranges that were established after testing a large group of people (reference ranges). Reference ranges may vary among different labs and hospitals. For this test, common reference ranges are:

• Adults
  • Total protein: 6.4–8.3 g/dL or 64–83 g/L (SI units).
  • Albumin: 3.5–5 g/dL or 35–50 g/L (SI units).
  • Globulin: 2.3–3.4 g/dL.
    • Alpha1 globulin: 0.1–0.3 g/dL or 1–3 g/L (SI units).
    • Alpha2 globulin: 0.6–1 g/dL or 6–10 g/L (SI units).
    • Beta globulin: 0.7–1.1 g/dL or 7–11 g/L (SI units).
• Children
  • Total protein:
    • Premature infant: 4.2–7.6 g/dL.
    • Newborn: 4.6–7.4 g/dL.
    • Infant: 6–6.7 g/dL.
    • Child: 6.2–8 g/dL.
  • Albumin:
    • Premature infant: 3–4.2 g/dL.
    • Newborn: 3.5–5.4 g/dL.
    • Infant: 4.4–5.4 g/dL.
    • Child: 4–5.9 g/dL.

Normally, there is slightly more albumin than globulin, which makes the albumin/globulin (A/G) ratio slightly over 1.

What do the results mean?

The results of this blood test will give your health care provider information about your general health. Many conditions can cause test results to be outside the normal range.

• High total protein may suggest:
  • Liver infection.
  • Disease of the bone marrow.
  • Other infections.
• Low total protein may suggest:
  • Liver disease.
  • Kidney disease.
  • Malnutrition.
  • Inflammatory bowel disease.
• An A/G ratio lower than 1 may suggest:
  • Bone marrow disease.
  • Inflammatory disease.
  • Scarring of the liver (cirrhosis).
  • Kidney disease.
• A high A/G ratio may suggest white blood cell cancer.

Talk with your health care provider about what your results mean.

Questions to ask your health care provider

Ask your health care provider, or the department that is doing the test:

• When will my results be ready?
• How will I get my results?
• What are my treatment options?
• What other tests do I need?
• What are my next steps?

Summary

• You may have the “total protein” and “albumin to globulin ratio” test as part of a routine physical exam or if you are having unexplained symptoms.
• This test measures the level of proteins in your blood.
• The results of this blood test will give your health care provider information about your general health.
• Talk with your health care provider about what your results mean.